ASH 2014
Comment: T cell therapy for children with aggressive leukaemia
Dr Catherine Bollard - Texas Children's Hospital, Houston, USA
Now children with acute lymphoblastic leukaemia, Stephan Grupp was talking about CAR T-cell therapy. It’s quite a recent therapy but now the results are looking quite interesting. What did you make of the work that he’s presented here?
When you look at the patients that he was treating, many of these patients had already relapsed post-allogeneic stem cell transplant, which is usually a death sentence for these children. You could see his amazing clinical results with complete responses, over 90%. Not all were durable, it’s true, but amazing, dramatic responses with such a therapy that is purely directed at the CD19 antigen.
How easy do you think it will be to engineer these T-cells on a larger scale to harness this CAR T-cell technology in everyday use for clinics?
There are challenges to overcome because at the moment there’s one product for one patient. It’s still personalised medicine. It does fetch the bone marrow transplant model in that regard, that you have a product specifically for that patient. But the involvement of pharma now is extremely exciting and will really help push the field forward for this therapeutic. There are obviously caveats or cautionary tales, given that there are toxicities associated with this therapeutic, especially in patients who have a lot of tumour burden. So we have to better understand how to manage those side effects, especially when we broaden applicability beyond centres who have experience in this type of therapy clinically.
